Incidence and management of olaratumab infusion-related reactions Journal Article

Authors: Van Tine, B. A.; Govindarajan, R.; Attia, S.; Somaiah, N.; Barker, S. S.; Shahir, A.; Barrett, E.; Lee, P.; Wacheck, V.; Ramage, S. C.; Tap, W. D.
Article Title: Incidence and management of olaratumab infusion-related reactions
Abstract: PURPOSE: Olaratumab is a human monoclonal immunoglobulin G1 antibody against platelet-derived growth factor receptor-α. We report the nature and frequency of infusion-related reactions (IRRs) with olaratumab in clinical trials and postmarketing reports. METHODS: Data from patients exposed to olaratumab across nine clinical trials were reviewed for IRRs. Blood samples were also analyzed for pre-existing immunoglobulin E anti-galactose-α-1,3-galactose (anti-α-Gal) antibodies. RESULTS: In the clinical trials, IRRs were identified in 70 of 485 patients (14.4%). The most frequent symptoms included flushing, fever or chills, and dyspnea. For 68 of 70 patients (97.1%), the first IRR occurred during the first two cycles of treatment. Grade 3 or worse IRRs were reported in 11 patients (2.3%), all during the first infusion and usually within 15 minutes of the start of the infusion. One IRR-related fatality (0.2%) occurred in a nonpremedicated patient with grade 3 or worse cardiac comorbidities. There was an association between grade 3 or worse IRRs and pre-existing anti-α-Gal antibodies, with a trend toward higher IRR rates in US geographies known to have a higher prevalence of anti-α-Gal antibodies. IRRs in postmarketing reports were consistent in nature and severity with those in the clinical trials. CONCLUSION: Premedication with corticosteroids and antihistamines should occur in all patients before olaratumab infusion, as indicated in labels in the United States and the European Union. Patients receiving olaratumab should be monitored for IRRs in a setting where resuscitation equipment is available for the treatment of IRRs.
Journal Title: Journal of Oncology Practice
Volume: 15
Issue: 11
ISSN: 1554-7477
Publisher: American Society of Clinical Oncology  
Date Published: 2019-11-01
Start Page: e925
End Page: e933
Language: English
DOI: 10.1200/jop.18.00761
PUBMED: 31268811
PROVIDER: scopus
PMCID: PMC6851793
Notes: Article -- Export Date: 2 December 2019 -- Source: Scopus
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  1. William Douglas Tap
    162 Tap